An intervention promoting the use of a “sunless” tanning product among women at a beach reduced their sunbathing behavior and sunburns acquired for the remainder of the summer, according to a report in the September issue of the Archives of Dermatology.
The intervention also had a long-term effect, as many of the women reported that they decreased their sunbathing and used the fake tanning product again the following summer, said Sherry L. Pagoto, Ph.D., of the University of Massachusetts, Worcester, and her associates.
The researchers assessed the intervention in women who visited two public beaches in Massachusetts in June and July of 2006 and agreed to participate in a study of sunbathing. A total of 125 subjects at one beach were assigned to the intervention and 125 at the other beach served as a control group. The mean age was 31 years.
The intervention included completing a brief questionnaire on sunbathing behavior, receiving written and verbal instructions on the use of a sunless tanning product and free samples of the product, receiving a pamphlet about skin cancer, having their photograph taken with an instant UV-filtered camera to demonstrate sun damage on their skin, receiving free samples of sunscreen, and being strongly encouraged to use sunless tanning rather than sunbathing. The control subjects completed the questionnaire, had their picture taken with a regular instant camera, and were given free cosmetic samples unrelated to skin health.
All study subjects had a 2-month follow-up for assessment of the short-term effects of the intervention, as well as at 1 year for long-term assessment.
At short-term follow-up, women in the intervention group reported that they had reduced their sunbathing by 33%, compared with a 10% decrease reported by the control subjects. The intervention group also said they had acquired 73% fewer sunburns, compared with 37% fewer reported by the control subjects. In addition, the intervention group said they had increased their use of protective clothing by 32%, while the control group said they had done so by only 2%. All of these between-group differences were statistically significant.
At long-term follow-up, the intervention group still reported a significant decrease in sunbathing behavior and showed a significant increase in the use of sunless tanning products, compared with the control group. The differences in the number of sunburns and the use of protective clothing did not persist.
The use of sunscreen increased slightly in both groups at short-term follow-up, but the difference between groups was not significant. And the increased use of sunscreen did not persist the following year.
These findings suggest that “promoting sunless tanning to sunbathers in the context of a skin cancer prevention public health message may be helpful in reducing sunbathing and sunburns and in promoting the use of protective clothing,” Dr. Pagoto and her colleagues wrote (Arch. Dermatol. 2010;146:979-84).
“Physicians might be reluctant to recommend sunless tanning due to concerns that it might inadvertently reinforce the patient’s desire to be tan,” they noted. However, these results suggest that instead, physicians should encourage patients who sunbathe to consider safer alternatives such as sunless tanning.
This study was limited in that nearly half of the women who were approached to participate in the study refused to do so, which could have contributed to selection bias. Also, the outcome measures relied on self-report, which may have contributed to social desirability bias. Finally, studies on the safety of the long-term use of sunless tanning products are lacking, and the long-term effects on the epidermis of dihydroxyacetone, the principal component of such products, remain unknown, the investigators noted.
This study was supported in part by the National Cancer Institute. Dr. Pagoto and her associates reported no financial conflicts of interest.